Microbial composition and antibiotic resistance of biofilms recovered from endotracheal tubes of mechanically ventilated patients

Abstract

In critically ill patients, breathing is impaired and mechanical ventilation, using an endotracheal tube (ET) connected to a ventilator, is necessary. Although mechanical ventilation is a life-saving procedure, it is not without risk. Because of several reasons, a biofi lm often forms at the distal end of the ET and this biofi lm is a persistent source of bacteria which can infect the lungs, causing ventilator- associated pneumonia (VAP). There is a link between the microbial fl ora of ET biofi lms and the microorganisms involved in the onset of VAP. Culture dependent and independent techniques were already used to identify the microbial fl ora of ET biofi lms and also, the antibiotic resistance of microorganisms obtained from ET biofi lms was determined. The ESKAPE pathogens play a dominant role in the onset of VAP and these organisms were frequently identifi ed in ET biofi lms. Also, antibiotic resistant microorganisms were frequently present in ET biofi lms. Members of the normal oral fl ora were also identifi ed in ET biofi lms but it is thought that these organisms initiate ET biofi lm formation and are not directly involved in the development of VAP.